Anger and bad behaviour with ADHD

All children behave badly from time to time and sometimes get aggressive, but it's more common for children with ADHD to have problems with their behaviour.

This is because the core symptoms of hyperactivity, impulsivity and inattention all affect the way your child interacts.

If you look at how these symptoms can affect a child's behaviour, it's easy to see how they are linked to bad or aggressive behaviour.

Hyperactivity causes a child to fidget, run about excessively, talk excessively and have difficulty in playing quietly. It can cause your child to accidentally damage others' belongings, play too roughly and hurt other children.

Impulsivity causes a child to blurt out answers, speak before thinking, interrupt, barge into games and have volatile moods. It can result in your child having a short fuse and to lash out when frustrated.

Inattention causes poor attention to detail and problems with following instructions. A child with inattention problems may not appear to listen to requests.

Dealing with these behaviours can push parenting and teaching skills to the limit. This means children with ADHD often receive a lot of negative feedback and critical comments – potentially contributing to problems with self-esteem, low mood and anxiety.

It's thought that these negative parenting and relating styles increase the likelihood of aggressive behaviour that, if unchecked, can lead to oppositional disorder or the more severe conduct disorder.

Children with ADHD are significantly more likely to have oppositional or conduct disorder than other children.

Tackling aggressive and bad behaviour

Put simply, there are two parts to tackling any behavioural problem:

encourage the behaviour you want through rewards, praise, attention (sometimes described by behavioural psychologists as 'positive reinforcement')

Children with ADHD thrive on consistency and routines, so to improve the chances of good behaviour, let them keep to their routine – such as getting up, eating or leaving for school at the same time each day.

Look at your approach

If your child is often naughty, disruptive and rude, it may seem as if you are constantly nagging and criticising – which can wear both of you down. If this sounds like you, it may help to code your child's behaviour using the 'traffic light system' below.

Green behaviour: things you'd like them to do more, eg politeness to house guests, niceness to siblings or helping with chores.

Amber behaviour: things that are OK, but might lead to a bigger problem eg running with a drink in their hand, cheekiness or snapping at requests.

Categorising your child's behaviour this way means you can decide what really needs tackling and stops every request turning into a battleground.

Finally look at whether you can avoid the problem altogether. For example, if there are particular situations that always trigger trouble, it may be worth trying to avoid them for a while, eg trips to the shopping mall or supermarket or playing outside the house.

Rules, rewards and discipline

Rules set the boundaries for acceptable and unacceptable behaviour. Rewards and discipline then enforce the rules. This sounds simple, but as parents know all to well, is difficult in practice.

Rules need to be clear, especially for children with ADHD.

Rewards

Give simple rewards for good behaviour.

Rewards need to be chosen carefully and fit the behaviour.

They shouldn't be too big or too small – this is known as the Goldilock Principle.

Change and update rewards, depending on how your child reacts.

Set simple, specific rules for behaviour, eg homework before TV. Discuss them with your child to make sure she's understood them.

Enforce rules you've set. For rules to work, they need to be fixed, not flexible. Don't be tempted to make the rules up as you go along. If your child challenges a rule, clearly restate it. Use punishments if necessary.

Be consistent. It's tough and tiring doing this all the time, but it's worth it to encourage good behaviour. If you're not consistent, your child will pick up on it and you could find yourself back at square one dealing with a child who thinks they can get away with anything.

The most effective way of enforcing rules is to decide on them together with your child – so agree in advance things such as bedtimes, how long friends can come over and play for, etc.

Where possible, make sure you give your child a good reason for the behaviour you want. For example, tidying your room will mean it's easier for you to find things.

Ways to reduce bad behaviour

Discipline tips

Get your child's attention. Address them by name and speak clearly.

Keep commands short and simple.

Give quick punishments that can be enforced now.

Try not to provide inadvertent , sometimes sought after attention, by involving yourself too much discussion or debate – keep it short and firm and mean what you say, and see it through.

it's inconsistent – one day you punish fighting with an early bedtime, the next you don't.

Examples of punishments

Natural consequences may be enough to stop the behaviour. For example, if you throw your drink on the floor, you don't get another.

Time-out can be helpful in dealing with tantrums. This is when your child has to sit out for a brief amount of time – usually about five minutes. For older children, a good rule of thumb is one minute for every year of age. The idea is to give your child a chance to calm down, and perhaps you also. An example would be to get your child to sit at the foot of the stairs or in a corner.

Losing privileges such as pocket money or games console can also discourage bad behaviour. It's a good idea to limit these punishments to a set period – for example one day, so your child has a chance to start the next with a clean sheet.

Avoid punishments that have the potential to harm your child either physically or psychologically, eg insulting your child publicly.

After the incident

Punishment tips

Be careful not to reward bad behaviour, eg items you buy after a tantrum on a shopping trip could be seen as a reward.

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